Kate E. Fiske

Treatment integrity of school-based behavior analytic interventions: a review of the research.

A growing body of evidence suggests that treatment integrity of school-based behavior analytic interventions is related to intervention outcomes. These findings are of importance to behavior analysts, educators, and other practitioners working in school settings, and indicate that these professionals should be knowledgeable in the assessment of treatment integrity. In this article, we describe the methods used to measure treatment integrity in research and summarize the findings on consultation characteristics that affect treatment integrity. Based on the reviewed research, recommendations are offered to behavior analysts and school professionals to aid in the measurement and maintenance of treatment integrity in school settings.

Use of Discontinuous Methods of Data Collection in Behavioral Intervention: Guidelines for Practitioners

Over the past three decades, researchers have examined the sensitivity and accuracy of discontinuous data-collection methods. Momentary-time sampling (MTS) and partial-interval recording (PIR) have received particular attention in regards to their ability to estimate the occurrence of behavior and their sensitivity to behavior change compared to continuous data collection. In this article, we summarize these findings and provide recommendations for designing a discontinuous measurement system with consideration of the dimensions of behavior to be measured and the expected direction of behavior change.

Evidence-Based Practice for Autism Spectrum Disorders

Publisher Summary The treatment of autism spectrum disorders remains a very confusing topic for consumers. Claims of effective treatments abound, and few consumers understand how to accurately interpret the available information. As a result researchers and professionals have taken steps to identify the comprehensive programs and focal methods that are most effective in treating autism and its accompanying symptoms. This chapter reviews the current state of information regarding evidence-based treatment for autism. Various definitions of evidence-based treatment and the criteria used to evaluate different treatments are reviewed. Several strategies in applied behavior analysis (ABA) are highlighted, as they clearly have the largest preponderance of evidence supporting their effectiveness. ABA remains the only intervention with substantial documentation of effectiveness. A variety of focal ABA treatments are shown to be highly effective, and evidence exists for the Lovaas/UCLA comprehensive treatment package though more research is needed to provide additional empirical support for this model. ABA is committed to continually increasing knowledge regarding effective intervention. In addition, a variety of strategies that are not empirically validated but which are in common use are reviewed. Finally, recommendations for both professionals advising consumers and for consumers navigating treatment decisions are delineated.

Treatment of Autism Spectrum Disorders

concepts, a directive approach, and family involvement (Anderson & Morris, 2006). Although further research is required to gain a better understanding of diagnosis and treatment of AS, researchers agree that treatment for AS should begin early in development. Because of the high academic functioning of many children with AS, diagnosis can occur later than it does in children with autism (Eisenmajer et al., 1996). Early detection and intervention in areas of social understanding and social skills is essential in the treatment of AS. Again, one should recognize the importance of a detailed assessment of the strengths and deficits of each child to develop the most appropriate individualized education plan. Family members should be involved at all stages of treatment to facilitate generalization of learned skills, and to increase family understanding and management of challenging behavior (Tsatsanis, Foley, & Donehower, 2004). Comprehensive treatment in the areas of social, behavioral, cognitive, and emotional development may vastly improve the quality of life for the child with AS. Functional Assessment and Treatment Children on the autism spectrum exhibit a wide range of challenging behavior, including aggressive, self-injurious, and disruptive behavior. Some behavior may be severe and intrusive enough to warrant a behavior intervention plan informed by a functional behavioral assessment (FBA). An FBA is defined as “a process which searches for an explanation of the purpose behind a problem behavior” (OSEP Questions and Answers, 1999) and is mandated by the Individuals with Disabilities Education Act (IDEA) Amendments of 1997 in cases in which a child’s behavior has resulted in negative educational outcomes. Specifically, FBAs are mandated when the behavior has resulted in the child’s suspension or placement in an alternative setting either for 10 consecutive days or because a due process hearing officer has determined the behavior is dangerous to the student or others, or when a student is placed in an alternative setting for 45 days when he or she has been involved in a weapons or drug offense. Although children with autism may infrequently meet these extreme requirements, IDEA also stipulates that if an individual’s behavior interferes with his or her learning or the learning of others, or poses a danger to the individual or others, then the student’s individual educational plan (IEP) team should implement a behavior intervention plan informed by a functional behavior assessment to address the behavior. These stipulations apply to many children with autism. Unfortunately, IDEA does not specify what elements constitute either an FBA or an effective intervention. We summarize here the components of a functional behavioral assessment and also discuss the importance of using the results of an FBA to inform and develop a function-based intervention for challenging behavior. Functional Assessment Iovannone, Dunlap, Huber, and Kinkaid (2003) conducted a review of comprehensive treatments for children with autism and found that one of the TREATMENT OF AUTISM SPECTRUM DISORDERS 307 components common to all effective treatments was a functional approach to challenging behavior. Although a child’s behavior may often appear unpredictable and random, most professionals in the field agree that all adaptive and maladaptive behavior is functionally and lawfully related to events in the environment and serves a purpose for the individual (Northup et al., 1991). An FBA is used to identify this function of a behavior so that an appropriate, function-based treatment can be implemented. In the context of functional assessment, behavior is maintained by either positive reinforcement or negative reinforcement, that is, by environmental stimuli that are either added to (i.e., positive reinforcement) or removed from (i.e., negative reinforcement) the environment following the occurrence of a behavior that subsequently increases the likelihood of that behavior occurring again in the future. Examples of positive reinforcement may include the presentation of attention, desired items, or pleasurable sensory input, and examples of negative reinforcement include the removal of demands or other aversive environmental stimuli or physical sensations. A behavior may function to gain access to any of these forms of reinforcement and, additionally, the behavior may function to gain access to several forms of reinforcement simultaneously (Northup et al., 1991). The purpose of a functional assessment is to determine which of these myriad functions currently maintains a maladaptive behavior so that an effective intervention can be developed. Prior to either the functional assessment or development of a behavior intervention plan, one must develop an operational definition for the challenging behavior. An operational definition defines the behavior as a measurable observable event, thus reducing biased reporting of the behavior and increasing the reliability of measurement of the behavior (Cooper, Heron, & Heward, 2007). Accurate assessment and treatment of the behavior will rely heavily on accurate data collection and measurement of the behavior. Without data and measurement, one cannot determine conclusively that a behavior has been reduced.

Assessing the value of token reinforcement for individuals with autism

The use of token systems has been supported across a variety of populations, but little research has evaluated the reinforcing value of token systems for individuals with autism. We used progressive-ratio schedules to compare the reinforcing value of an established token system, primary reinforcement, and tokens unpaired with reinforcement. Token systems were variably reinforcing for 2 students with autism and more so than primary reinforcement for 1 student. Results support formal assessment of the effectiveness of token systems.

A brief assessment for selecting communication modalities for individuals with Autism Spectrum Disorders

Abstract Individuals with autism spectrum disorders (ASD) have impairments in their ability to communicate with others. Estimates indicate that about 25–50% of children with ASD are nonvocal. To address these deficits, a number of augmentative and alternative communication strategies have emerged. Commonly used communication responses have included vocal speech, picture exchange, and manual signs. While these communication strategies have all been shown to be effective in specific clinical instances, the selection of communication topography has generally been based on philosophical preference, rather than on empirical analyses. Relatively little research has evaluated procedures to determine which modality represents a “best fit” with individual learning styles. The purpose of the current investigation was to design a brief assessment model to evaluate the rate of acquisition and preference for different communication modalities for three individuals with ASD. The results show that participants acquired different modalities of communication at different rates and displayed clear preferences for different styles of communication. These findings suggest that this procedure may help to empirically determine which communication system represents a best fit for individual learners.